The likely outcome of this year’s health care push is that we will get a medium-size bill that expands coverage to some groups but does relatively little to control costs.

The costs of dealing with climate change would rise further still by 2050 when the bill envisages an 80% cut in us greenhouse gas emissions.

He is anxious to ease the pain the bill will cause in the short term, though he says he believes that the costs of doing nothing will, in the long term, be much greater.